RH Reality Check has identified at least a dozen instances of women experiencing miscarriages, stillbirths, and ectopic pregnancies in jails and prisons across the country, in circumstances that show a shocking lack of medical care from the professionals charged with providing it.

This is the second article in RH Reality Check’s Women, Incarcerated series. You can read the first piece in that series here.

On the morning of September 11, 2011, Krystal Moore thought she was dying. Sharp pain stabbed at her stomach, so much so that she curled up into a fetal position on her bed. She didn’t know what was happening. Though she was pregnant, she was only six months along, not nearly ready to give birth.

She couldn’t simply call the family doctor. She was an inmate, serving time at the Jerome Combs Detention Center in Kankakee, Illinois, for smoking marijuana while on probation. But in the early hours of that Sunday morning, her pain was escalating quickly.

“I woke up hurting,” she told RH Reality Check. “I tried to get in the shower, and I couldn’t.”

She asked to go the hospital. She had spoken to some other inmates, and she began to think she was having contractions. The pressure on her stomach was getting worse.

Krystal Moore

A guard telephoned the jail nurse, Ivetta Charee Sangster, to tell her that Moore was having stomach pains. Sangster was on duty that Sunday, though she wasn’t actually at the detention center, which, like many jails, doesn’t have full-time medical staff available, despite housing a sick and vulnerable population. Even if Sangster had been there, she was only a licensed practical nurse, a role that generally involves providing only very basic medical care, like taking a patient’s blood pressure or changing a bandage. She would not have been able to give Moore the urgent care she required for what had become a serious infection of her womb.

Meredith Manning—Tennessee, 2004

Twenty-three-year-old Manning began to miscarry in a Corrections Corporation of America facility. She bled for two days before she was taken to the hospital, where she gave birth to a baby that died shortly after. This case settled for $250,000.

Sangster sounded irritated on the phone, according to the transcript of the call that later appeared in a lawsuit filed by Moore.

“Krystal Moore, she’s—in my opinion, a lot of times she’s full of shit,” Sangster told the guard. “You can go eyeball her and call me back if you want. She’s probably full of shit. But you can let her know that she can see the doctor tomorrow if she’d like.”

Our attempts to contact Sangster were unsuccessful.

By 2:30 that afternoon—at least eight hours since she first alerted guards to her pain—Moore began bleeding while sitting on a toilet. Screaming out of pain and fear, she was finally taken to a local hospital, but not before being forced to walk down the stairs from her cell to the ambulance, according to a court opinion from December 2013.

Moore was fully dilated by the time she arrived at the hospital, where she says she was shackled to the hospital bed. Then, around 5:20 p.m., she gave birth to twins. Had she been taken to hospital earlier, there was a possibility that the babies could have survived, according to an expert who provided evidence for the lawsuit. Instead, one baby lived for only a day; the other survived for 16 days.

“I remember it clear as yesterday. I think about my twins every day and every night. How would they be?” Moore said.

Shela Williams—Texas, 2014

Williams was 18 weeks pregnant when she entered a Texas jail. She had a high-risk pregnancy but did not receive adequate obstetric care while incarcerated. When a doctor finally did examine Williams, he told her that her child “wasn’t going to make it.” She went to a nearby hospital, where she delivered her stillborn; she was not allowed to attend his funeral.

Moore’s case settled last year for $620,000, according to her lawyer. But in a five-month investigation, RH Reality Check found that her story is not unique. After reviewing more than 200 legal cases, as well as the Human Rights Defense Center’s database of “Deaths in [Corrections Corporation of America] Custody,” RH Reality Check identified at least a dozen instances of women experiencing miscarriages, stillbirths, and ectopic pregnancies in jails and prisons across the country, in circumstances that show a shocking lack of medical care from the professionals charged with providing it.

This number is most likely a dramatic under-representation of the problem. In addition to the shame and grief that many women feel at the loss of a pregnancy, incarcerated women often fear complaining about their miscarriages behind bars because they do not want to compromise ongoing cases or face retribution from jail or prison staff, according to community activists and researchers who work closely with incarcerated women.

Bethany Cajúne—Montana, 2009

Although Cajúne was pregnant, and both her doctor and drug treatment counselor had prescribed her continued use of Suboxone (a medication that suppresses withdrawal symptoms) in jail, the doctors and nurses there would not give her the prescription. She went through immediate withdrawal, losing ten pounds in less than two weeks. She feared she would lose her baby. Finally, after nine days, a public defender intervened and she received the treatment. This case settled in 2011.

To be sure, low-quality prenatal care is a symptom of the larger problem of poor medical care in corrections facilities in the United States, as has been documented in California, Arizona, and Florida and through thousands of lawsuits against prisons and the private contractors that sometimes run them.

Prison health services were so bad in the 1960s and 1970s that in 1976 the U.S. Supreme Court ruled that failure to provide appropriate medical care to prisoners amounted to a violation of the U.S. Constitution’s prohibition on cruel and unusual punishment. As a result, incarcerated people are the only group in the United States with a constitutional right to medical care.

The cases we examined were strikingly similar to Moore’s: pregnant women waiting weeks to see doctors, nurses instructing women to take antibiotics for labor pains, and inmates miscarrying in toilets or on cell floors. Sangster’s comments would have fit into any of the cases that we read. Again and again, we saw women inmates in need of prenatal care ignored, silenced, and disbelieved.

Gretchen Harbison—Indiana, 2010

Harbison could not feel her fetus move for three days. She was eventually transferred to a hospital, where she delivered a stillborn. Harbison alleges that the prison doctor failed to treat her pregnancy with any urgency, despite knowing that she had four complicated deliveries in her past.

“I feel like that jail done killed my kids,” said Moore. “I’ve been feeling that since the day I gave birth.”

Prenatal Care Is Crucial—and Missing—Behind Bars

At the end of 2012, there were more than 200,000 women in prisons and jails, comprising 9 percent of the nation’s incarcerated population. Based on current trends, the number of women behind bars is expected to grow.

The median age of women in state and federal prison is 34, and the majority of incarcerated women are of reproductive age, according to a study by the Bureau of Justice Statistics. Many women in prison have high-risk pregnancies, complicated by problems including poor nutrition, domestic violence, mental illness, and drug and alcohol abuse.

Poor prenatal care in corrections facilities is a grave concern, especially since those facilities have become one of the major providers of health care for marginalized communities, according to Brad Brockmann, executive director of the Center for Prisoner Health and Human Rights at the Miriam Hospital in Providence, Rhode Island, an affiliate of Brown University.

“For many of the individuals who come into the system, their first physical as adults is when they enter prison or jail, because prior to January 2014 Medicaid was not available to many, with only safety-net programs available in the community,” Brockmann said.

Tiffany Pollitt—Pennsylvania, 2010

An inmate hit Pollitt in the stomach; she repeatedly reported the incident, but no doctors or nurses took her seriously. She continued to say she was in serious pain. Corrections officers told Pollitt to “grow up,” asked her what she expected them to do, and told her “better luck with next shift.” Then Pollitt bled all over the floor of her cell. Finally, she was transferred to a nearby hospital, where she delivered a stillborn baby.

The quality of prenatal care provided by prisons or jails varies wildly between and within states, with most facilities providing very poor care, according to a 2010 review of state policies by the National Women’s Law Center and the Rebecca Project.

The survey graded all 50 states on their treatment of mothers behind bars. Thirty-eight states received a failing grade in the category of prenatal care. The researchers reported that 43 states do not require medical exams as part of prenatal care for women in confinement. Forty-eight states don’t offer pregnant women screening for HIV.

And this review only examined what states said their policies were; there were no on-site inspections. “Paper reviews are of limited value in a corrections context,” said Amy Fettig, senior staff counsel for the ACLU’s National Prison Project.

The reality is, no one is looking closely at what is happening in practice on a national scale when it comes to the care of incarcerated pregnant people, experts told RH Reality Check.

DeShawn Balka—Georgia, 2012

Balka was about 24 weeks pregnant when she entered the jail. She experienced nausea, cramping, bleeding, and vaginal discharge, which she reported to jail guards. No one examined her. Then she began experiencing extreme pain and cramping. She sat on the toilet in her cell and pressed the emergency call button; no one responded. Ultimately she gave birth into the toilet. Her baby was pronounced dead at the hospital a few hours later.

For instance, there are no clear answers to some fundamental questions, such as how many women are pregnant during incarceration each year in the United States. A 2011 report by the American Congress of Obstetricians and Gynecologists put the number at 6 to 10 percent of incarcerated women, while a 2008 study by the Bureau of Justice Statistics estimated that between 4 and 5 percent of women admitted to state and federal prisons that year were pregnant.

There are also no comprehensive data for the number of pregnant women in jails, which typically house people prior to conviction or sentencing, or sometimes for immigration matters or for shorter sentences.

And there is simply no national picture of pregnancy outcomes—miscarriages, abortions, stillbirths, and live births—for incarcerated women, experts told us. The most recent data we could find came from 1998, when the Government Accountability Office reported that there were about 1,400 births in prisons that year.

Only two states require collection of data on pregnancy outcomes for incarcerated women—Delaware and Oregon, according to the Rebecca Project report. Delaware did not respond to our request for records, but Oregon provided information recorded about the only state prison that houses women, Coffee Creek Correctional Facility, between July 2012 and November 2014.

Countess Clemons—Tennessee, 2011

Eighteen-year-old Clemons started miscarrying in a prison in Tennessee. After leaving her in a cell for almost three hours, guards took Clemons to a hospital, where she delivered a baby who died soon after he was born. This case settled for $690,000 in 2014. The Corrections Corporation of America was also issued a sanction for destroying video evidence of the delay in treatment.

That data say there were 51 pregnant prisoners during that time, but give little insight into the type of care provided to these women, apart from the indication that some women were assessed to see whether their pregnancies were high-risk. Of these pregnancies, 37 resulted in births while incarcerated. Eleven women had c-sections, and three women’s labor was induced. There was one miscarriage and one abortion, and an additional four women returned a negative pregnancy test after earlier indicating that they were pregnant. At the time the data were provided, seven of the pregnant prisoners remained incarcerated, while at least two had been released prior to giving birth.

The data do not cover jails, which are governed separately by each of Oregon’s 36 different counties, according to Wendy Smith, a spokesperson with the state’s Health Services Administration.

It’s therefore reasonable to imagine that thousands of women around the country are experiencing a wide range of pregnancy outcomes while in jails and prisons, with no oversight mechanism to track the care they receive.

But most states do not collect data on incarcerated pregnant woman, and there is no national set of data about prenatal care or pregnancy outcomes for incarcerated people.

Experts say this lack of national and local data is no coincidence.

“It’s one of the many areas where the lack of data points to the invisibility of incarcerated people, and specifically incarcerated women,” Tamar Kraft-Stolar, director of the Correctional Association of New York’s Women in Prison Project told RH Reality Check.

Nicole Guerrero—Texas, 2012

Guerrero began to experience pain, bleeding, and cramping, and alerted medical staff. Guerrero was put in solitary confinement, where she went into labor by herself on the floor of her cell. The umbilical cord was wrapped around the baby’s neck, and the baby was later pronounced dead. Guerrero was made to stay in solitary confinement while the infant was taken away.

Despite the lack of comprehensive national data, our investigation found that, with few exceptions, prenatal care in prisons and jails across the country is shockingly inadequate.

For Laila Batts, poor prenatal care behind bars came close to ending her life.

In early January 2007, Batts was detained for ten days at the Elmwood Complex Women’s Facility, in Santa Clara, California, after writing a bad check to pay some bills.

Batts was in her first trimester of pregnancy the day she entered jail, and that night she began to experience spotting and severe cramping. For the next ten days, Batts complained to nurses about her pain.

By Monday, January 8, Batts told jail staff that she wanted to go to the hospital, because her condition was getting worse. Her request went unfulfilled. On January 9, a nurse saw Batts bleeding on the floor of her cell and complaining that her symptoms were getting dramatically worse, but the nurse did not send for emergency help. When Batts finally saw a doctor the next day, January 10, the doctor noted that she was suffering from an abnormal pregnancy, was at risk of an ectopic pregnancy, and required care, according to records produced in the lawsuit. But instead of providing that care, the doctor sent Batts back to her cell. Batts thought she was suffering a painful miscarriage.

“What started out as a request for modified community service in light of her pregnancy turned into a near-death sentence, bringing Ms. Batts within hours—perhaps minutes—of losing her life,” court filings said.

The day after she was released from jail, Batts woke in excruciating pain and was rushed by ambulance to the emergency room, where, she told RH Reality Check, surgeons removed her ectopic pregnancy, as well as a fallopian tube. Ectopic pregnancies are extremely dangerous, and require immediate attention to avoid potential death of the pregnant person.

Latish Durden—Georgia, 2012

Durden had a high-risk pregnancy and had surgery on her cervix while at the jail. She required constant monitoring. She began experiencing cramping, bleeding, and discharge, but she was not treated. Eventually she was taken to the hospital, where she delivered a stillborn baby.

Batts settled her case, but declined to say how much she was awarded.

What is unusual in her lawsuit is that the complaint focused on the physical and mental pain that she endured. The vast majority of cases we examined focused on the loss of the fetus, not on the suffering of the pregnant woman, because the law tends to focus more on permanent losses—the death of a “viable” fetus—than on temporary pain experienced by the woman. For this reason, we found more cases involving stillbirths (a loss of pregnancy after 20 weeks’ gestation) than miscarriages, which occur prior to 20 weeks.

And because many miscarriages are difficult, if not impossible, to prevent, it is extremely difficult for women who have suffered them while incarcerated to prove any fault on the part of the authorities. This makes mistreatment of miscarriage tough to detect, with even grassroots community advocates struggling to identify where it has occurred.

Diana Claitor, executive director of the Texas Jail Project, says she usually doesn’t hear about a miscarriage from the woman who suffered it.

“Mostly we get a grandmother calling,” Claitor told RH Reality Check. “The first call I got was an elderly Hispanic woman asking, ‘Is there any way we can get the body of our dead grandchild and put it in the family plot?’”

“Sanctity of Life in Texas Looks Like This”

Many of the cases of miscarriage or stillbirth we found occurred in states that have recently introduced laws that claim to protect fetuses, even at the expense of the woman bearing them.

For example, miscarriage in Texas is treated differently if it does not happen behind bars.

Last year, Dallas police swarmed a high school after a fetus was found in a toilet. They launched an investigation, reviewing video footage and interviewing teachers to find the “suspect.”

But two years earlier, no such attention was given to the case of Autumn Miller, who in the summer of 2012 miscarried into a toilet while serving a one-year sentence at the Dawson State Jail, also in Dallas.

Miller, who in pictures has light brown hair and a warm smile full of straight, white teeth, was already the mother of three children. She had entered the jail in February, after violating probation on a drug possession charge, not realizing she was pregnant.

Throughout May and June, Miller complained of cramps and fatigue, and requested a pregnancy test and Pap smear. She never received either from the jail.

On the night of June 14, Miller began bleeding, and experiencing pain so severe that she couldn’t walk, according to a lawsuit filed against the Corrections Corporation of America. Miller told guards she felt like she was having a baby.

Guards brought her to a medical unit where a nurse waited on a telescreen (like the jail in Kankakee, there was no full-time medical staff on-site). But Miller could barely explain what was happening before a guard turned off the screen, handed her a menstrual pad, and locked her in a segregated cell.

Screaming, Miller gave birth into a toilet. She was then handcuffed, shackled, and transported to the hospital separately from her newborn. Miller named the infant Gracie Robinson; she barely weighed a pound. Gracie died four days later.

“They had her locked in a cell down in the medical area, all by herself, when she was laboring, unbeknownst to her,” Miller’s lawyer, Paula Sweeney, told RH Reality Check. “Then they couldn’t find the key to get the door open when it became apparent what was going on. Then, as she’s laying there on the cot, with blood everywhere, in terror and agony, the male guards start taking pictures with their cellphones.”

Miller’s case was settled in January 2014, and the facility that housed her has since been shut down because of budget cuts as well as increased scrutiny about what was going on behind the prison walls.

“Texas runs around bragging about the sanctity of human life, until you get a chance to see it in real life,” Miller’s lawyer told us. “Sanctity of life in Texas looks like this.”

No Role for Prosecutors in Prenatal Care

Experts have a wide range of recommendations to improve pregnancy care in prisons and jails, including laws that require tracking and reporting pregnancy outcomes, the elimination of solitary confinement for pregnant prisoners, and an increase in inmates’ access to OB-GYNs.

In Texas, a coalition of groups, including the Texas Jail Project and the ACLU of Texas, is pushing for a bill that would mandate tracking of prenatal care and treatment of pregnant prisoners in the state’s approximately 250 county jails.

The bill has caused unease among some women’s advocates, however, because of fears that gathering data on pregnant inmates could lead to more punitive action by the state.

“There is legitimate fear from legislators that are interested in doing this kind of tracking that those numbers will be used to punish pregnant women for drug use,” Mathew Simpson, policy strategist at the ACLU of Texas, told RH Reality Check. “When it comes down to it, if we don’t know the birth outcomes, we can’t make an assessment of where the gaps are.”

The broader picture, however, is that jails and prisons are generally the wrong place to house pregnant women, given that they frequently lack the appropriate staff or facilities, and are fundamentally geared toward punishment, not care.

“Judges and prosecutors think that it’s a good idea to empower jail guards—whose job is to punish criminals—to give prenatal care,” Lynn Paltrow, the executive director of National Advocates for Pregnant Women, told RH Reality Check. “There has to be a very clear consensus that there is no role for prosecutors to be involved in prenatal care.”

]]>http://rhrealitycheck.org/article/2015/03/31/deprived-care-incarcerated-women-suffer-miscarriages-stillbirths-ectopic-pregnancies/feed/3I Had an Ectopic Pregnancy, and Anti-Choice Laws Could Have Made My Experience Much Worsehttp://rhrealitycheck.org/article/2015/02/04/ectopic-pregnancy-anti-choice-laws-made-experience-much-worse/?utm_source=rss&utm_medium=rss&utm_campaign=ectopic-pregnancy-anti-choice-laws-made-experience-much-worse
http://rhrealitycheck.org/article/2015/02/04/ectopic-pregnancy-anti-choice-laws-made-experience-much-worse/#commentsWed, 04 Feb 2015 16:55:28 +0000http://rhrealitycheck.org/?p=53223

This isn't how I wanted any of this to go. I didn't go to my ultrasound hoping for a political statement; I wanted a due date.

Last Thursday, I was about to go to the admitting office on the hospital grounds where I’d come for my ultrasound appointment. Before I left, I just had to ask the OB-GYN receptionist, to make absolutely sure: “Is this a Catholic hospital?”

The receptionist hesitated and then asked one of the nursing staff who’d come up if she knew what faith the chaplain was. I turned to the nurse. “No, that’s not why I asked,” I said. “The last time I had a problem with a pregnancy, I had Catholic health care and they sent me home to miscarry. I want to know that they offer a full range of medical care here.”

She understood and said no, it wasn’t a Catholic hospital. She said they were checking me in because they thought this was serious and they planned to treat me immediately. I probably looked a little dazed. She found someone to walk us to admitting and make sure we didn’t get lost.

My ultrasound appointment had started as scheduled, at 3 p.m. that day. I figured we’d hear the heartbeat for the first time, go home with a blurry, indecipherable black-and-white image, and start planning in earnest for a new baby. We already had a nickname. But the tech said she was having trouble finding it. She didn’t play us the heartbeat and said she had to go get the doctor. She was so caring toward us afterward, but I bet she cleans up at poker.

Then the doctor came in and explained that it was a tubal, or ectopic, pregnancy. Modern medicine can perform many wonders, but a tubal pregnancy can’t be saved. If it’s not removed in time, it’s a serious health risk to the pregnant person. As the doctor explained to me, since it was far enough along to hear a heartbeat, they considered this an emergency situation.

By 5:30 p.m., I was in a hospital bed talking with nurses and doctors about how soon they could get me into surgery, considering that I’d eaten half a granola bar at 2:30. I was shocked and panicked. I was grieving. I was having a hard time being still so they could get the IV started. I was probably not a fun patient, but everyone was about as kind as anyone could hope.

It wasn’t my first time as a surgical patient. As a child, I’d had appendicitis that waited too long for treatment because my parents delayed to find a doctor who would perform major abdominal surgery on a 7-year-old and agree not to use blood transfusions under any circumstances. Jehovah’s Witnesses. It turned into full-blown peritonitis, infection of the entire abdominal cavity. The treatment required two surgeries, rearrangement of my intestines and other organs to clean the infected tissue, more than a week in intensive care, and three months overall in a hospital.

During that hospital stay, the nurses had a hard time keeping IV needles in my arms. That was a problem because my digestive system had come to a complete stop, and it was the only way to feed me. One day, my mother counted, they’d had to replace the IV needle 14 times. I had near-daily blood tests. There was one test where they had to fill several large vials from the one site, and they took so much blood that my arm hurt too much to move it for three days. It made an impression. Needles terrify me. I can’t logic my way out of it. Sorry in advance, every phlebotomist I will ever meet.

Then there was the other surgery, for that problem pregnancy. The one that had started miscarrying by the time it could be diagnosed because I had a massive ovarian cyst that had gone undetected through years of no medical care at all. The doctors said it was urgent, but they couldn’t operate until I’d miscarried. Catholic health care. What if I don’t miscarry, I asked. But you are miscarrying, they said. They sent me home, increasingly shaky and too bent over with cramps to walk straight, until the pregnancy was officially over. I was so weak I passed out during one of my pre-surgery blood tests and was shaking for an hour until I could get something to eat. Then they had me do a 24-hour fast, drink something horrible that kept me throwing up all night, and brought me in for a surgery that I was surprised to wake up from missing an ovary. Someone forgot to discuss that with me in advance as a possibility.

So when one of the doctors last Thursday came to bring me consent forms and said that a possible result of the surgery they were getting me ready for was the removal of an ovary—while one very patient nurse was trying to put an IV in my arm and another was trying to take my medical history—I may have started backing up the incline of the hospital bed, saying something like, “No, you can’t! I only have one!”

Party in my room, everyone’s disinvited.

I calmed down enough to explain the previous surgery and to let my saintly nurse get the IV started. The doctor left to regroup. After a little while, another doctor came in. They’d looked at the pictures again.

She said she could see I was scared. She said there was no better place for me to be under the circumstances. I had to admit that she was right. She said she wanted to keep that remaining ovary as much as I did, because otherwise she’d have to treat me for hot flashes. She said it looked like the attachment point was also all the way on the other side, near where the missing ovary would have been, and that while they might have to take out a small piece of the uterus, there should be no long-term problems.

I thanked her with all my heart. I felt I could trust that she would be making decisions in the operating room that I’d agree with. I relaxed a little for the first time that evening, and my husband and I were able to have some time together to deal with the news.

I was talking to the anesthesiologist by about 9:30 p.m. that night. He told us it would probably be about three hours, and not to worry if it went a little long, not to feel rushed about going home. My husband held my hand as we went down the hall, my son’s grandparents brought him to the end of the ward so I could give him a kiss before going in, and shortly after that I stopped remembering things for a while.

I woke up to a new scar and not pregnant. And very, very grateful for my life. I got to go home to my family that weekend. Thank you, doctors. Thank you, nurses. Thank you, everybody who reached out to us.

Other things I’m grateful for include the many benefits of living in a state that hasn’t been taken over by misogynist barbarians who like tormenting women at what may be the worst moments of our lives. Or creating worst moments of our lives on purpose.

For instance, the doctor wasn’t required to tell me lies about the risks of removing that life-threatening pregnancy while I was also freaking out about whether or not I was going to wake up missing bits of me again. The ultrasound tech was allowed to be decent and compassionate toward us, instead of being forced to play us the sound of that doomed heartbeat and describe what few anatomical features she might have seen, even as my husband and I were both crying over what we’d suddenly realized was our loss. The only waiting period they had to be concerned about was the safe time they could operate based on when I’d recently eaten. I’m grateful that I was able to walk into that health-care facility without a sidewalk circus of nasty strangers talking to me about a baby that wasn’t coming, or calling me names as I went by and blocking my way during a very hard walk, or shouting at my heartbroken husband that he needed to “man up” and stop me.

I’m grateful that during this medical emergency, my doctors were allowed to follow only their best judgment about what care would keep me healthiest, according to the most current standards of their profession. Their only legal concern was my safety. The police had no part in our story. If you want to imagine me at this moment, picture me thumbing my nose at every meddling anti-choice medievalist who was prevented from making a terrible week even worse and threatening my health to boot.

Ectopic pregnancies are dangerous, and the only way to treat them is through a termination. If I were less well-off and in a rural part of a state like Texas, where low-income prenatal care has been nearly demolished in a blunt, smashing fit of rage at abortion providers, I might have had to forgo that routine ultrasound visit and just had to hope everything was fine until I could plan a trip out of town or get to my turn on a long waiting list. I might not have been lucky enough to be near three major hospitals that could admit me at once, where several doctors on staff were willing to take my case without hesitation.

A doctor might not have seen me until the growing embryo and placenta had caused a rupture and internal bleeding, until I’d felt cramps, or felt faint, or maybe passed out from blood loss. They might not have been able to get important details about my medical history if they hadn’t been able to wake me up first, or begun emergency surgery unprepared for the mass of internal scarring and missing organs I told my doctors to expect.

Or they might not have gotten to me in time at all. Because pregnancy is dangerous. It’s dangerous when everything goes right. It’s very dangerous when anything goes wrong.

Modern medicine has given us many wonders. But I think that makes it easy to forget, or to conveniently obscure, that every pregnancy is a risk. We can forget that every pregnancy is so risky that, if it weren’t a pregnancy but a procedure, we would have to sign a thick pile of consent forms and liability waivers to undertake it. If it weren’t a pregnancy, we’d have to opt in for it, rather than have moralizing strangers talk about why we should be forced to stick with it, hell or high water. Pregnancy without modern obstetric care is more dangerous than a kidney transplant, with a high child mortality rate for the trouble, and even now, you just never know.

This isn’t how I wanted any of this to go. I didn’t go to my ultrasound hoping for a political statement; I wanted a due date. And odds are, you’re not one of the handful of people I was planning to share my news with this week. But it happened like it did, and there’s nothing to do but to lie here until this scar heals up some more and try to get my head around the facts of the situation.

Writing has become part of dealing with things like this for me. But as long as I’m at it, I couldn’t help but think about all the ways it could have gone differently if anti-choice laws prevailed where I live. It would have been worse in every way, for no sound reason. The best care I could have gotten was the immediate care that I did get. The best information I could have gotten was the medically accurate information that I did get. For women all over the country, when they’re faced with a pregnancy they have to decide to end—and I trust without hesitation that their reasons are right for them, because who would know their lives better than they do—it is worse in every way.

Because messing with this aspect of someone else’s life should always be seen as the torture that it is. Torture inflicted on unknown women because they didn’t have the political power to demand humane treatment and a right to bodily self-determination.

If you think you know better than women whether we should be pregnant at any given time, that’s how I will always think of you. As a torturer. As someone who would have heartlessly complicated my family’s tragedy without knowing or caring anything about us. And on this, we will be enemies, until you finally decide to recognize the fullness of women’s humanity and our own right to our lives.

I don’t like war metaphor. I prefer to think about reproductive justice advocacy in terms of healing and love. But when our nonsensical policies on drugs and reproductive health claim the lives of living, breathing people, it feels like a war.

Jamie Lynn Russell was 33 years old when she went to an emergency room in Pauls Valley, Oklahoma in such debilitating pain that she was unable to move. Because her excruciating pain prevented her from lying down for an examination, hospital staff labeled her “noncompliant,” and called the police. The police discovered that she had two pain pills that weren’t hers. Still in pain, she was released by the hospital as “fit to incarcerate,” arrested for drug possession, and taken to jail, where she died two hours later from a ruptured ectopic pregnancy.

Two pain pills.

Much of the initial response to the case centered around the actions of the hospital, which likely amount to malpractice. But we must avoid making the mistake that the hospital did: looking at individual actions when they are merely symptoms of deeper, deadlier problems.

Jamie’s needless death shows us where our priorities lie, misplaced: chasing down minor drug offenders in service of a failed war on drugs is more important that human life and dignity; women’s health is not taken seriously and “noncompliance” is cause for punishment. The tragedy of her death once again disproves the myth that women never need abortions and that “modern technology and science” have eliminated maternal mortality.

I hope that her family—and people across Oklahoma and the United States—will demand justice for Jamie so that she is not just another unnamed casualty of the many political and rhetorical wars waged on pregnant women.

Reports from Mississippi are mixed. The fate of Initiative 26 may hinge on voters like the pro-life woman whose stepdaughter had an ectopic pregnancy – and whose life was saved by a medical procedure that would be banned if the amendment passes.

Reports from Mississippi are mixed. A respected journalist said on the Diane Rehm Show earlier this week that the personhood amendment will pass overwhelmingly. Initiative 26 opponents on the ground say opposition is growing as people begin to understand how extreme the initiative is. Even Gov. Haley Barbour doesn’t like it. If polling has been done, it has not been made public so we really don’t know what voters will do Tuesday, Nov. 8. What I learned from participating in the Religious Coalition for Reproductive Choice’s phonebank to Mississippi voters this week was enlightening. Most people have made up their minds, one way or the other, and they’re not talking – or listening; a few still have not heard about Initiative 26 (for example, one woman who had just returned home from two weeks in the hospital), and a few are still unsure, including a woman whose story left me convinced there is hope for defeating this awful legislation.

A busy young mother I spoke to put it bluntly: “You mean the abortion thing?” When I said yes, she continued: “You mean whether the mother dies or the baby?” I said yes again. She said she knew how she was voting – against 26. After all, she’s a mother and knows the terrible consequences of forbidding medical treatment to a pregnant woman.

An older woman said she knew all about it – two of her granddaughters, who are students at local community colleges, are going door-to-door to talk to people about the amendment, along with several of their friends. She said many people did not understand the harmful consequences of the amendment and her granddaughters and their friends are educating them. We agreed that young people – at least these young people – aren’t apathetic. She is very proud of them.

What gave me the most hope was a long conversation, about 12 minutes. The woman I spoke to was a middle-aged working mother who defined herself as pro-life. At first, when I mentioned the reasons why the amendment is so bad – it would ban birth control and in vitro fertilization, ban all abortions even in cases of rape – she said she had heard that wasn’t true. We discussed the amendment in more detail and she said: “It’s so complicated. I wish things were simpler, like they used to be.” She said she felt like she was living in Russia because there was so much government control these days. Finally, she said what was really on her mind. Her stepdaughter had had an ectopic pregnancy – and her life had been saved by a medical procedure that would be banned if the amendment were passed and changed laws regarding abortion. It took a relatively long phone call to get to that point – and when we hung up she still wasn’t sure about how she would vote. But she’s thinking about it, and that may be the best we can do in the final hours before Tuesday, Nov. 8.

]]>The Illinois House is using the conservative Agriculture Committee to pass anti-choice bills, North Dakota is looking at a personhood bill, and Sen. Lautenberg and Rep. Lee introduce a bill banning federal funding of ineffective abstinence programs.

An Illinois House Committee has been busy with abortion-related bills recently. It recently passed a bill requiring clinics to fulfill the requirements of surgical centers, which could be devastating financially for many clinics in the state. What committee is hearing all these bills? Inexplicably, the Agriculture Committee, prompting protesters to wear buttons emblazoned with a cow and the words “Women are Not Livestock.” Apparently, the committee is full of conservatives from “downstate,” and when a House member introduces an anti-choice bill, he or she can request that the bill be sent to the Agriculture Committee to ensure passage.

A North Dakota legislator has introduced a bill to “make abortion a criminal act,” by making it state law that a fertilized egg is a human being. The embryo would be subject to protection from assault, reckless endangerment, and homicide whilst in the womb. While the bill includes exceptions for life-threatening conditions, in vitro fertilization, and emergency contraception, two doctors testified that the bill would complicate the treatment for women with ectopic pregnancies, fetuses who are found to have severe developmental problems, and in vitro fertilization.

Although the measure exempts in vitro fertilization from criminal penalties, it includes language saying that “causing injury to a human being” is not justified. Dr. Stephanie Dahl, a Fargo infertility specialist who works at North Dakota’s only in vitro fertilization center, said the bill would make it illegal to do the procedure. “The process of IVF may result in injury to an embryo,” Dahl said. “It is unavoidable.”

Not surprisingly, the bill is being pushed by Personhood USA.

Senator Frank Lautenberg (D-NJ) and Rep. Barbara Lee (D-CA) have introduced a bill banning federal funding of abstinence-only programs. The “Repealing Ineffective and Incomplete Abstinence-Only Program Funding Act” would strike the main source of funding for the programs, and instead fund $50 million a year of comprehensive sexuality education programs that include abstinence.

]]>http://rhrealitycheck.org/article/2011/03/16/morning-roundup-lautenberg-introduce-bill-banning-funding-abstinenceonly-programs/feed/2Denied treatment for a miscarriage or ectopic pregnancy? We want to know.http://rhrealitycheck.org/article/2011/02/18/denied-treatment-for-miscarriage-or-ectopic-pregnancy-we-want-to-know/?utm_source=rss&utm_medium=rss&utm_campaign=denied-treatment-for-miscarriage-or-ectopic-pregnancy-we-want-to-know
http://rhrealitycheck.org/article/2011/02/18/denied-treatment-for-miscarriage-or-ectopic-pregnancy-we-want-to-know/#commentsFri, 18 Feb 2011 12:10:48 +0000Here at the National Women’s Law Center we are trying to identify instances where this practice may have occurred. What happens when women with pregnancy complications go to the emergency room for treatment? If you or someone you know has experienced a delay or denial of treatment, we want to know. Help us bring this hidden issue out from the shadows: share your story with us.

Some institutions and individuals allow religious doctrine, and not evidence based medical care, to dictate the kind of treatment that pregnant women can receive. This is because these health care providers consider any intervention that ends the pregnancy to be an abortion; even in cases where there is no medical treatment that would allow the pregnancy to continue, and the woman could suffer serious harm if she does not get treatment quickly.

Here at the National Women’s Law Center we are trying to identify instances where this practice may have occurred. What happens when women with pregnancy complications go to the emergency room for treatment? If you or someone you know has experienced a delay or denial of treatment, we want to know. Help us bring this hidden issue out from the shadows: share your story with us.

If you went to an emergency room with symptoms of miscarriage or ectopic pregnancy, even if you were not treated there, we still want to hear from you. We understand that this survey touches on a sensitive matter, and all responses will be kept strictly confidential.

Yes, you heard right. Sharron Angle believes that the neurodevelopmental disorder know to medical science as “autism” is actually a government-backed hoax to redistribute wealth from hardworking health insurers to pesky kids and their greedy parents.

Angle trashed the notion that insurance companies should have to cover “Autism” (air quotes are hers).

Angle was caught on tape promising to abolish mandatory insurance coverage for autism. “Everything that they want to throw at us is covered under ‘autism’,” Angle told the American Association of Underwriters this summer, tracing scare quotes with her fingers as she said “autism.”

…By saying that you don’t think there should be health care for autism, I take it that you don’t think that children, and individuals, with disabilities are in need of such things—living with their families and in their communities, healthy and safe, being loved and cared for? Being treated as we would all like to be?

The fact that Angle opposes mandated coverage for private insurers should concern voters, especially since she wants to privatize all government health care programs. In other words, Angle wants to turn health care over to the private sector and stamp out public competition. And yet, Angle’s campaign admits that the candidate and her husband receive both government health care and a Civil Service pension, according to Eric Kleefeld of TPM. If Angle is so morally opposed to government health care, she should set an example by declining the coverage.

Andy Kroll of Mother Jones has more on Angle’s record: She once told impregnated rape victims to buck up and make “lemons out of lemonade” by bearing their attacker’s child. Angle also denounced people on unemployment insurance as “spoiled.”

Food vs. health care

It may soon get even harder for poor families to make ends meet. The Senate is poised to slash the extra food stamp benefits in the stimulus before they expire. The Senate already raided $6.7 billion from the the so-called “food stamp cookie jar” to bail out Medicaid and save teachers’ jobs at the state level. Now they want to take even more money to fund the child nutrition bill.

The cuts would fund a marginal improvement in school lunches, notes Monica Potts of TAPPED. That’s all well and good, but why provide slightly better weekday lunches if the poorest children get less at every other meal?

Annie Lowery of the Washington Independent interviews anti-hunger activist Joel Berg about the cuts. Berg says that if the cuts go through, families will have to make do with considerably less than the current $4.50 per person per day. He notes that Congress wants to cut food stamp benefits in the face of rising food prices.

When families make do with less, healthy foods like fruits and vegetables will be the first casualty. Berg argues that it is economically short-sighted to prematurely terminate one of the most efficient economic stimuli in the entire stimulus package:

And we know that we aren’t only feeding people. We come at this from a moral position, a nutritional position, and an economic recovery position. This cut is so insane from an economic position as well — we know food stamps are the most effect form of stimulus. The jury is still out on parts of the stimulus — but the jury isn’t out on food stamps. It was a 1,000 percent, beyond home run grand slam success, if you’ll excuse me mixing metaphors. The money went to people who needed it, rapidly, and without a lot of bureaucracy.

In the Progressive, Ruth Conniff has a personal take on the politics of improving school lunches. Her kids’ school got a USDA Fresh Fruits and Vegetables grant to introduce more local produce into school meals.

“Bridalplasty”

The laws of Reality TV: 1) The most important thing in life is to be very beautiful so that a man will want to marry you; 2) You have until your wedding day to make yourself look like someone else.

The E! network is launching a new reality show in which brides-to-be receive free cosmetic surgery to make them look acceptable for their Special Day, as Stephanie Hallett reports at Ms. blog. Hallett notes that armchair psychiatrists are already diagnosing the contestants with Body Dysmorphic Disorder, a condition that causes sufferers to become obsessed with imagined physical imperfections.

Hallett also argues that competitive plastic surgery shows like Bridalplasty and The Swan are dramatic exaggerations. Labeling the contestants as “sick” or “crazy” implies that they are limited-edition freaks, not individuals on the extreme end of a continuum of self-loathing that affects most women.

Ectopic pregnancy

Anti-choicers have already attacked hormonal birth control as crypto-abortion. Their next target may be lifesaving surgery for a deadly complication of pregnancy. At RH Reality Check, Lon Newman writes about a young woman that survived a life threatening ectopic pregnancy.

An ectopic pregnancy occurs when a fertilized egg takes root outside the uterus, nearly always in a fallopian tube. Tubal pregnancies are among the deadliest gynecological emergencies because the woman can rapidly bleed to death if the tube ruptures. Obviously, once a fertilized egg takes root outside the uterus, there is no chance that it will survive. However, some anti-choice extremists still maintain that treating ectopic pregnancies is a kind of abortion.

One of the ectopic pregnancy survivor’s friends actually told her that she should have respected “God’s will” and refused lifesaving surgery. “I have had friends who said that I should have ‘gone with God’s will,’ imposing their beliefs on my will to live,” the woman said.

]]>http://rhrealitycheck.org/article/2010/09/30/weekly-pulse-sharron-angle-mocks-insurance-autism-fight-save-food-stamps/feed/1Nicaragua: Working for Safety Despite Abortion Banhttp://rhrealitycheck.org/article/2008/05/08/nicaragua-working-safety-despite-abortion-ban/?utm_source=rss&utm_medium=rss&utm_campaign=nicaragua-working-safety-despite-abortion-ban
http://rhrealitycheck.org/article/2008/05/08/nicaragua-working-safety-despite-abortion-ban/#commentsThu, 08 May 2008 07:20:00 +0000After more than a hundred years of legally allowing women access to a therapeutic abortion, in October 2006 the Nicaraguan National Assembly banned this procedure in all circumstances. Now women's health groups are working to mitigate the damage.

Editor’s Note: With this post we welcome Karim Velasco, a
lawyer based in Lima, to RH Reality Check. Karim will join our
Global Perspectives team reporting on reproductive and sexual health
and rights issues internationally.

After more than a hundred years of legally allowing women access to a
therapeutic abortion if her life or health was in danger, in October 2006 the Nicaraguan National Assembly
banned this procedure in all circumstances under pressure from conservative
movements and the church. A year later,
despite international pressure and claims to respect the human rights of women,
the hopes and efforts of women’s rights organizations and medical associations
were shattered when a new Penal Code reaffirming the ban was approved in
September 2007 by the National Assembly.

Although
in January 2007 a
group of civil society organizations filed an appeal to the Supreme Court to
declare the amended provision unconstitutional, the appeal had to be
resubmitted since the Penal Code had been rewritten.

Besides the importance of drawing a legal strategy to challenge the ban on
constitutional grounds, it is necessary to think of the consequences and
challenges that this ban is already bringing to public health. The CEDAW
Committee, Pan-American Health Organization (PAHO), UNFPA and the Interamerican Commission of Human Rights
among others warned the Nicaraguan government of the alarming effects that the
ban on therapeutic abortion would have not only on women’s lives and health
but also on health service providers’ behavior.
And it is now clear that clandestine abortions and maternal mortality rates
have spiraled since the ban was introduced.

According
to UNICEF,
the adjusted maternal mortality ratio is estimated to be 170 deaths for every
100,000 live births, one of the highest in the region. PAHO, Human Rights Watch (HRW), and IPAS have
documented cases of women who died because they were denied or delayed
treatment for obstetric emergencies, mainly because of the fear of prosecution or
misperception of the law on the part of medical personnel. Some women have reportedly
tried to get medical treatment because of constant bleeding or proved ectopic pregnancies
but were left unattended for hours or transferred to a different health center,
which in some cases led to their deaths. Women
have no choice but to look for emergency obstetric care elsewhere, even though
in many cases they need to be treated for incomplete miscarriages that have
nothing to do with induced abortions.

The
ban on therapeutic abortion is not only affecting the access to emergency
obstetric care, it is also affecting the quality in delivering the service. ForIPAS
the ban has a double impact on the health system: i) the economiccosts of
treating these preventable emergencies, caused by delays in care, consume a
major portion of the health sector’s limited budget, and ii) health
providers find themselves having to choose between appropriately treating the
patients by ignoring the law or denying them the necessary care to preserve
their health and lives.

It
is also important to highlight the fact that not only medical staff fear
prosecution. Women also fear seeking treatment because they are afraid of
being accused of having induced an abortion themselves. This vicious circle is
certainly affecting the most vulnerable women, that is, young poor women. IPAS
has even pointed out that "75 percent of the maternal deaths recorded this year
[2007] were women who lived in rural areas and more than 80 percent were
adolescents and youth." Although the
strong link between adolescent pregnancy and poverty is not new, the ban on
therapeutic abortion severely worsens the risks for these women.

Up
to now the only serious attempt carried out by the government to mitigate
consequences of the ban was the issue of "mandatory protocols for the provision
of emergency obstetric care." In December
2006 the Ministry of Health issued the Norms
and Protocols for Treatment of Obstetric Emergencies. According to Human Rights Watch these
guidelines "cover most if not all obstetric emergencies, including ectopic
pregnancies and post-abortion care. If fully implemented, it is possible that
these guidelines could overcome a good part of the negative consequences of the
blanket ban." However, HRW’s research also shows that doctors and health
officials are not willing to implement the guidelines; they usually ignore them
or delay their implementation due to fear of prosecution. It is not clear to them
whether the protocols are compatible with the ban or not, which usually leads
to leaving patients unattended or turning them away from the hospital. Unfortunately, the Ministry of Health "does
not monitor the full implementation of protocols, does not systematize complaints
received for the delay or denial of care, and so far has not studied the impact
of the law on the lives and health of women."

PAHO
and Human Rights Watch
have issued a list of recommendations to the Nicaraguan government to amend the
Penal Code and decriminalize
therapeutic abortion, guarantee women immediate access to emergency
obstetric services and postabortion care and appropriately implement the
guidelines on emergency obstetric care. HRW
additionally called on donors and United Nations agencies to expand funding for
reproductive health related programs in Nicaragua and to support campaigns
seeking to educate women about their right to access contraception.

In
an attempt to lessen the impact of the ban IPAS Central America‘s
work is not only focusing on "ensuring access to high-quality postabortion care
(PAC)", but has also included among its activities "improving the availability
and quality of abortion-care services in the context of comprehensive
reproductive health care."

Similarly,
it is imperative that additional initiatives are implemented to mitigate
the impact of the ban on women’s lives and mental and physical health,
especially by the government and national organizations.